Anesthesia for emergency abdominal surgery

Carol Peden; Michael J Scott

doi:10.1016/j.anclin.2014.11.012

Anesthesia for emergency abdominal surgery

Anesthesiol Clin. 2015 Mar;33(1):209-21. doi: 10.1016/j.anclin.2014.11.012.

Authors

Carol Peden¹, Michael J Scott²

Affiliations

¹ Royal United Hospital, Combe Park, Bath BA1 3NG, UK. Electronic address: cpeden@nhs.net.
² Department of Anesthesia and Perioperative Medicine, Royal Surrey County Hospital NHS Foundation Trust, Surrey, Guildford GU1 7XX, UK; Surrey Perioperative Anesthesia Critical Care Research Group (SPACeR), University of Surrey, Surrey, Guildford GU2 7XH, UK.

PMID: 25701936
DOI: 10.1016/j.anclin.2014.11.012

Abstract

Emergency abdominal surgery has a high mortality, with an incidence of around 15% for all patients. Mortality in elderly patients is up to 25%, and 1-year mortality for emergent colorectal resection for patients over 80 years is around 50%. Patients presenting to hospital are often given low priority. Definitive surgery is not always possible and it may be more important to control the septic focus and to revisit surgery later. The literature is poor for such a common procedure, but there is evidence that a standardized pathway focusing on rapid diagnosis; resuscitation; sepsis treatment; and, if appropriate, urgent surgery followed by admission to intensive care improves outcomes.

Keywords: ELPQuIC bundle; Emergency surgery; Enhanced recovery; High mortality; Laparotomy; Sepsis; Surviving Sepsis.

Publication types

Review

MeSH terms

Abdomen / surgery*
Anesthesia*
Anesthesiology / methods*
Emergencies
Humans
Sepsis / complications